KEY TAKEAWAYS
- The study assessed the real-world eligibility and use of avelumab maintenance in la/mUC patients.
- The results showed that nearly half of 1st-line PBT patients couldn’t get maintenance due to disease progression or death, emphasizing the demand for new treatments.
Patients diagnosed with locally advanced or metastatic urothelial carcinoma (la/mUC) often undergo first-line platinum-based chemotherapy (PBT).
Following this treatment, avelumab maintenance (maintA) is suggested, as it has shown improved survival rates compared to the best supportive care in the JAVELIN Bladder 100 trial. Yet, there’s a lack of information regarding the number of eligible patients for maintA and those who actually receive it in real-world US clinical settings.
A retrospective observational study aimed to determine the proportion of la/mUC patients eligible for and receiving maintA in clinical practice.
Utilizing the US-wide Flatiron Health database, researchers conducted an analysis, drawing from de-identified patient data, both structured and unstructured, across electronic health records.
It involved adults diagnosed with locally advanced or metastatic urothelial carcinoma (la/mUC) who underwent at least one round of first-line platinum-based chemotherapy (1L PBT) from April 2020 to January 2022.
The analysis aimed to determine eligibility for and usage of MaintA and assess patient outcomes. MaintA eligibility was based on criteria such as achieving complete response, partial response, or stable disease following 1L PBT.
A total of 336 patients with la/mUC revealed that the mean age was 70.1 years, with 72.6% being male. Among them, 55.4% received a cisplatin-based regimen, while the remaining received a carboplatin-based one. About 53.9% were considered eligible for maintA.
Among those not eligible for maintA, 71.7% experienced disease progression, and 28.3% faced death during or 1L PBT. Of the maintA-eligible patients, only 37.0% actually received maintA, making up 19.9% of the total 1L PBT-treated population. For those who received maintA, the average time to start it after 1L PBT was 1.0 month, and the duration of maintenance was 5.5 months.
Nearly half of the patients who started 1L PBT were not eligible for maintA, mainly because of disease progression (71.7%) or death (28.3%). Over 80% of the total group receiving 1L PBT did not receive maintA.
These findings underscore the necessity for innovative first-line treatments for individuals with la/mUC.
Source: https://suo-abstracts.secure-platform.com/a/gallery/rounds/18/details/3215
Clinical Trial: https://clinicaltrials.gov/study/NCT02603432
Morgans, A. K., Sonpavde, G. P., Shih, V. (2023). “REAL-WORLD ELIGIBILITY AND UTILIZATION OF AVELUMAB MAINTENANCE IN PATIENTS WITH LOCALLY ADVANCED OR METASTATIC UROTHELIAL CARCINOMA.” Presented at the 2023 Society of Urologic Oncology Annual Meeting, November 28 – December 1, 2023, Washington, DC. Abstract 61.
